The PARTNER Model: An Attachment-Based Practice Model for Providers Working with Mothers and Infants Impacted by Perinatal Opioid Use Disorders

There are an estimated 2.5 million people in the United States of America suffering from opioid use disorders. Of the 2.5 million Americans impacted by opioid use disorders, over half are women. One of the most challenging aspects of opioid use disorders occurs in the context of pregnancy. Discourse surrounding the topic of addiction often identifies the root cause of addiction as a moral failing, rather than a pathophysiological disease. This stigma is amplified in the context of pregnancy and perpetuates the false, discriminatory notion that pregnant women with opioid use disorders are knowingly “harming” their babies without regard. Instead of receiving support, education, and encouragement, pregnant women with opioid use disorders are faced with stigma, judgment, shame, and guilt. These negative interactions ultimately serve as barriers that interfere with the ability for early attachment bond development, a monumentally important piece of newborn development and the most significant contributor to healthy attachment development. These avoidable, institutionally created barriers propagate both short- and long-term risk factors for the mother and infant, both independently and as a dyad. This dissertation will systematically explore several aspects of perinatal opioid use disorders to develop an evidence-informed practice model for healthcare providers working with pregnant and postpartum women with opioid use disorders. This dissertation will also explore the intersection of perinatal opioid use disorders and attachment theory, which will serve as the framework for the PARTNER model, an attachment-based practice model for providers working with mothers and infants impacted by perinatal opioid use disorders. Composite case vignettes, informed by clinical experience and empirical literature, are integrated throughout this dissertation to illuminate and connect the critical concepts that set the foundation for the PARTNER model